Here & Now

ACA In Wisconsin: Impact On Providers

Frederica Freyberg:

One concern with the Affordable Care Act, how much of a strain will it put on the already understaffed healthcare industry? The US Department of Health and Human Services just announced $55 million in grants to increase training for nurses, dentists, and preventive medicine doctors. Some say mandated insurance coverage under the law will create a tsunami of new patients. It seems fair to say that remains to be seen.

Physician:

Hello, how are you today?

Patient:

Good, how are you?

Physician:

Good, nice to see you.

Frederica Freyberg:

A lot of ink has gone to how patients might fare under the Affordable Care Act, but what about providers?

Melissa Stiles:

I think for physicians in general, there are so many unknowns about it.

Frederica Freyberg:

Family practice doctor Melissa Stiles says the new law could stretch physicians thin.

Melissa Stiles:

For primary care, you know, you’re probably going to see an influx of patients. So the concern will be, are there going to be enough primary care providers to deal with the influx of patients. The unknown is how many people are going to sign up. So it’s this equation is yet to be played out.

Frederica Freyberg:

The equation has yet to be played out in part.

Woman:

It always gives me this, “your account couldn’t be created at this time.”

Frederica Freyberg:

Because of enrollment problems with the healthcare marketplace website healthcare.gov. Just how many people will be getting new insurance and new healthcare is in flux.

Robin Vos:

Which is why we are giving an additional three months for anybody in Wisconsin who is going to transition off of BadgerCare into the private exchanges, to get that done.

Frederica Freyberg:

Even more so, because due to delays and new legislation, patients moving off the state’s BadgerCare plan, for example, won’t have to seek insurance through the healthcare marketplace until April instead of the original January start date.

Michael Richards:

The goal is to get as many of the folks who are losing BadgerCare onto the marketplace.

Frederica Freyberg:

The point person on the Affordable Care Act at Gundersen Health in La Crosse is Michael Richards. What’s your expectation for the influx of newly-enrolled people coming into Gundersen?

Michael Richards:

Because of the marketplace, that remains to be seen at this point. There’s been a lot of glitches in the system. But we understand that those people that will need to get insurance probably have already come here, or have been in the area before, whether they’ve gone to the emergency room or waited too long and needed some other specialty care. So we hope that more people will get insured through the marketplace.

Frederica Freyberg:

Because Richards says if patients have insurance, they’ll come through Gundersen’s doors differently. Instead of using the emergency room as their primary care physician, they’ll be able to come in the front door and get preventive care, stemming off more expensive care. Gundersen is not just a medical provider. It’s also an insurer, with plans in the marketplace. It had to prove to the federal government that it could handle any influx of patients.

Kathleen Falk:

For the qualified healthcare plans to be approved and in the marketplace, there needed to be a demonstration of capacity. In Wisconsin, you know, we are blessed with a fabulous medical community of providers, and we have seen now through the marketplace that they were eager to respond to this new market and have made their plans available.

Frederica Freyberg:

As for that community of providers, we wondered about the most essential question, how will the healthcare law affect how doctors are able to care for their patients?

Melissa Stiles:

I don’t myself see a lot of changes. I know there have been concerns among physicians about increasing bureaucracy, but we already deal with that. This doesn’t really change the underlying structure of how we deliver healthcare.

Frederica Freyberg:

Dr. Stiles says she does have concerns about the Affordable Care Act, including the fact that it won’t cover everyone. There will still be uninsured, and whether it will actually reduce healthcare costs.